THE ROYAL COLLEGE of Nursing (RCN) Wales Board has issued a stark warning to the Welsh Government, urging immediate action to fix the nursing pay progression system or risk Wales falling behind the rest of the UK. Meeting in Cardiff on Thursday, the board highlighted growing concerns that stalled career advancement and pay structures are damaging morale, eroding trust, and deepening staff shortages across NHS services in Wales.
The call comes as nurses in other parts of the United Kingdom see concrete commitments to address similar issues. In England, ministers have pledged to review every Band 5 nursing role to ensure pay and banding accurately reflect the work performed, with dedicated funding for any resulting uplifts. Scotland has already begun this work, leaving Wales at risk of falling behind. Despite previous commitments from the Welsh Government during the 2023/24 pay negotiations, including promises to review career progression arrangements, nurses in Wales say they see no tangible results.
“Progression from Band 5 to Band 6 is broken,” said Jackie Davies, Chair of the RCN Wales Board. “The current system is failing nursing professionals and leaving skilled staff stuck in roles that do not reflect their expertise, responsibility or experience.” Pressure for reform is heightened by dissatisfaction with recent pay awards. The Welsh Government’s 2026/27 Agenda for Change pay settlement of 3.3 % for NHS staff was described by RCN Wales as “very disappointing” and effectively a real-terms pay cut given ongoing cost-of-living pressures.
Staffing crisis and graduate support
Recruitment and retention challenges compound these frustrations. A union report from late 2025 highlighted that NHS Wales was struggling to fill more than 1,400 registered nurse vacancies, a shortfall that is increasing pressure on existing staff, pushing up reliance on expensive agency workers and contributing to widespread unpaid overtime. This staffing crisis is reflected in recent industrial actions, with health visitors in parts of Wales beginning a month-long strike over incorrect pay banding that could be leaving staff thousands of pounds worse off.
RCN Wales has also emphasised the importance of funding preceptorship frameworks, structured support programmes for newly qualified nurses. While Wales already has a preceptorship framework, it remains unfunded, meaning graduates often lack the support their counterparts in England receive. Executive Director Helen Whyley said: “Previous commitments have not delivered change. The Welsh Government must now act decisively so nurses in Wales are not left behind their colleagues across the border.”
Beyond progression and graduate support, RCN Wales points to the Agenda for Change pay structure itself, introduced more than two decades ago, as a root cause of the problem. Nearly half of Welsh nurses remain at Band 5 for their entire careers, despite becoming highly experienced and qualified, a situation that hinders recruitment and retention and ultimately impacts patient care. With a general election looming in Wales, the RCN has called on the government and all political parties to put forward time-bound commitments to deliver meaningful pay progression and career pathways for nursing staff, warning that without clear plans and funding, Wales risks being left behind other UK nations in supporting its nursing workforce.
